Benefits of breastfeeding

There are so many benefits to breastfeeding but let’s start with the health benefits:

  • The antibodies in breastmilk protect your baby from all kinds of infection – this is particularly beneficial for premature babies who are more at risk

  • Your breastmilk is constantly changing according to your baby’s needs

  • Breastfeeding can reduce allergies, including CMPA, hayfever and asthma

  • Promotes bonding and produces hormones that make you and your baby feel happier

  • Contains everything your baby needs to be healthy and grow

And don’t forget the practical benefits:

  • It’s free

  • It’s always available – no late-night dashes to the supermarket!

  • No need to prepare bottles in the middle of the night

  • It’s environmentally friendly

It is recommended that babies are exclusively breastfed for at least the first six months. However, evidence shows that babies still benefit from having breastmilk for less time than this, and there are many benefits to feeding past six months too. The most important thing is to enjoy this special time with your baby.

Breastmilk

When your baby is born, you’ll produce colostrum, a thick yellow liquid that doesn’t look much like milk. Some women start producing colostrum before their baby is born – this can be collected and given to your baby when they’re born if you wish.

Colostrum is all your baby needs for their first few days. You won’t make much, but your baby’s tummy is about the size of a marble so they don’t need much at all. In most cases, you can start breastfeeding as soon as your baby is born – you’ll be encouraged to have skin-to-skin contact as soon as possible and this is a great time to latch your baby. Some mums like to give their baby time to allow their natural reflexes to work, by placing their baby’s tummy on their chest, and allowing the baby to find the breast and latch on. This is known as biological nurturing.

If your baby is in the Neonatal Unit or can’t latch for any other reason, you can hand express colostrum and collect it into a syringe, so that it can be fed to your baby orally or via a nasogastric tube.

After a few days, your milk will come in. Your body creates as much milk as your baby needs by replacing whatever they take out. Your milk will change in terms of thickness, consistency and fat content over time.

How often to breastfeed

This is different for every baby. There is no set length of time or frequency for breastfeeding. Breastfeeding should be responsive rather than scheduled – you should learn to recognise your baby’s feeding cues and respond to them before they become distressed. Cues include restlessness, wriggling, putting hands or fingers near or into their mouth, or rooting. Keeping your baby close to you will give you the opportunity to pick up on these cues and teach you how to respond to each other.

The amount of milk you produce is based on a supply and demand system, so the more your baby feeds, the more you’ll produce. Try not to get overanxious about it, as anxiety can affect your milk supply.

You can’t overfeed a baby when breastfeeding, so don’t worry if your baby feeds a lot. 8-12 feeds in 24 hours is completely normal. You may find that there are some days where your baby seems to be extremely hungry, and others where they go longer between feeds. This is normal and nothing to be concerned about, as long as your baby is having regular wet and dirty nappies and following their curve on their growth charts. If your baby isn’t feeding as much as normal and is showing any signs of dehydration, you should seek urgent medical advice.

Newborns have no internal clock, so might be awake most of the night. This is normal and is a positive thing, as the prolactin hormone that increases your milk supply is more active at night. Ask your partner or family to take over during the day so you can rest and try to sleep if you have fed your baby most of the night.

The lack of sleep and frequent feeding can be exhausting, but try not to give your baby formula milk, as your baby might then be less satisfied with subsequent breastfeeds, and their immunity to infection will be reduced as the flora in the gut will change. If you do give formula, you might find your baby will breastfeed less often, and you may not produce enough milk to satisfy their needs. Try to be patient and put your baby back on the breast again if they are restless and unsettled, or give a small amount of expressed milk. Avoid using dummies for at least the first few days until your milk has come in.

Is my baby feeding enough?

The Midwifery team will discuss and complete your personalised feeding assessments with you, to make sure you are happy with how breastfeeding is going, and that your baby is getting enough milk. They will ask you how you are finding your baby’s behaviour after feeds – are they relaxed and content, or crying and unsettled?

Your baby will be weighed a few days after birth, to check they haven’t lost too much weight. This will be checked again a few days later. Most breastfed babies lose some weight at first and can take up to two weeks to return to their birth weight. This is quite normal. Your baby’s weight will be recorded and plotted on a centile chart in your child health book (internal link). If there are concerns about your baby’s weight, your Midwife will explain this to you and discuss a reviewed feeding plan. This doesn’t neccesarily mean you will need to stop breastfeeding.

Your baby’s behavior, mood and the frequency and colour of their nappies will tell you whether they are getting enough milk – have a look at UNICEF’s checklist for breastfeeding mothers.

Latching and positioning

It’s important that your baby is positioned and latched correctly from the first feed. This will prevent you from getting sore nipples, and will make sure your baby is feeding effectively.

How to hold your baby for a feed:

  • Hold your baby close to your body

  • Make sure there is no pressure on the baby’s head

  • Hold them so that their head and body are in a straight line and not twisted

  • Position your baby’s nose opposite the nipple – your baby has to extend their head to achieve a correct feeding position

  • Make sure you’re comfortable and can maintain the position for a long time

There are lots of feeding positions you can use – in time you will find what works best for you and your baby. They may find it easier to feed in certain positions, and you may find some positions more comfortable than others. Read more about breastfeeding positions.

  • Your baby’s chin should be against the breast, so their nose is clear

  • Your baby’s mouth should be open wide

  • Your baby’s cheeks should be full and rounded

  • There should be more areola visible above your baby’s top lip than the bottom lip

  • You should see your baby sucking and then swallowing

  • Your baby should be relaxed and comfortable

  • You should not be experiencing any pain

Many women don’t realise that babies should not suck on their nipples – there should be no contact between your baby’s tongue or mouth and the nipple. Find out more about latching and positioning.

Nipple shields

Nipple shields are thin silicone covers which are placed over your nipple during breastfeeding. Most women do not need to use nipple shields in order to breastfeed, but they may be helpful as a temporary measure if:

  • Your nipples are damaged and this is causing pain during feeding

  • Your baby is premature or small for their age and is struggling to latch

  • You have flat or inverted nipples

In most cases, damage to your nipples is a result of incorrect latch, so it’s important to seek help to make sure that there are no problems with the latch, otherwise the damage will continue. Nipple shields will not fix damage to your nipples, they merely give damage a chance to heal while you keep feeding.

Nipple shields should be used for as short a period as possible – the aim should be to get your baby breastfeeding without the shields as soon as possible.

Common breastfeeding problems

Some women have the misconception that breastfeeding will be painful. In fact, breastfeeding should not be painful at all. You may have some nipple sensitivity, which is a normal physiological response, but if you are experiencing any pain you should ask your Midwife to check your latch and positioning. Other things can cause pain, such as thrush, mastitis, and vasospasm, so you should always talk to your Midwife, Health Visitor or GP if you are experiencing pain during or after breastfeeding.

Some women find that their nipples become cracked or sore. Ask a health professional for advice and assess feeding to check your babys’ attachment and positioning as this is the main cause of cracked nipples.

Read more about cracked nipples.

It’s completely normal to experience engorgement when your milk comes in, usually around 3-5 days after birth. Your breasts can feel heavy, hard and warm. Engorgement can be prevented by initiating early breast feeding, feeding frequently and making sure your baby is attached correctly.

Hand expressing a small amount of milk will soften the breasts before a feed if your baby is finding it hard to latch. Having a bath, shower or applying hot compresses (e.g. warm flannels or heat packs) to your breasts before a feed will help to increase the milk flow and prevent clogged ducts.

If you miss any feeds you may find you become engorged quickly – your body knows how much milk your baby needs and will continue to make it whether you feed or not. If you’re away from your baby for a few hours it’s a good idea to express or pump some breastmilk so that your breasts don’t become too full. Allowing milk to build up can lead to mastitis.

Most women who breastfeed on demand have no problems with supplying too much or too little milk. However, some things can impact your milk supply – certain medications, dehydration, being away from your baby without pumping (e.g. if you or your baby are in hospital), replacing breastfeeds with formula, or not pumping as regularly as your baby would feed can all affect your supply.

Some women produce more milk than their baby needs, which can lead to engorgement and mastitis.

If you are at all concerned about the amount of milk you’re producing, it’s important to speak to your Midwife or Health Visitor. Seek medical advice as soon as possible if you think your baby is dehydrated or is having fewer wet and dirty nappies than you’d expect.

Tongue-tie (also known as ankyloglossia) is caused by a tight or short membrane under the tongue (the lingual frenulum). The tongue-tip may appear blunt, forked, or have a heart-shaped appearance. The membrane may be attached at the tongue-tip, or further back.

Recent research suggests that as many as one in ten babies may appear to be tongue- tied, however less than half of them are likely to have feeding problems and not all tongue ties need to be treated.

For those babies with tongue ties who are struggling to latch, or causing pain and nipple trauma when breastfeeding, the tongue tie can be divided. This is a simple outpatient procedure called a frenulotomy, where the base of the tie is snipped with sharp, blunt-ended scissors. This doesn’t require anaesthetic or any stitches – there is usually little or no pain or bleeding. The baby can feed straight away and feeding usually improves within a few days.

Your Midwife can refer you to a tongue tie clinic at Poole or Dorchester if they are less than six weeks old. You can also self-refer to Salisbury hospital, or ask to be referred to Southampton hospital, if your baby is older

Read more about tongue-tie at NHS Choices.

Thrush is a fungal infection that can develop in your breast and spread to your baby’s mouth while feeding. Thrush usually causes pain in both nipples after feeding, creamy white spots or patches in your baby’s mouth, and severe nappy rash that doesn’t respond to regular creams. Thrush needs to be treated, so see your GP if you have any of these symptoms. Both you and your baby will need to be treated at the same time.

Read more about thrush at NHS Choices

Mastitis is inflammation of the tissues in the breast. It usually occurs in breastfeeding women, and is mostly caused by a build-up of milk within the breast, either because the baby is not feeding effectively, or because a milk duct has become clogged. However, it can also happen to women who are not breastfeeding.

Applying hot compresses before feeds to help the milk flow, and cold compresses after feeds, can reduce mild inflammation and prevent clogs that may lead to mastitis.

You should seek advice from your GP immediately if you think you might have mastitis, as it can progress very quickly.

The main symptoms are:

  • Usually affects onebreast
  • A red, swollen area on the breast that is painful and might feel hot to the touch
  • A lump or harder area in your breast
  • Discharge from your nipple (white or blood-streaked)
  • Burning pain in your breast (constant or only when breastfeeding)
  • Symptoms of an infection (e.g. chills, a fever, flu-like symptoms)

If mastitis is not treated, it can lead to a serious infection and / or abscess so it’s very important to see your GP urgently, or call 111 if out of hours. If you feel very unwell with a high fever and other symptoms of an infection, you should go to A&E or call 999.

You should continue to breastfeed regularly if you have mastitis, to prevent things from worsening and to maintain your milk supply. If it is too painful to breastfeed or you aren’t with your baby, you should express or pump regularly.